3 reasons why diagnosis is difficult

1. Our screening tests are inaccurate. A fundamental problem in identifying individuals with dyslexia is that existing operational definitions of reading disability produce unstable phenotypes—meaning someone could be identified as having a reading disability during one test, but not during a second test.

To improve identification of individuals with dyslexia, we need to combine information. Combining information about basic factors of dyslexia—such as poor non-word decoding, impoverished sight-word vocabulary, and phonological impairment—will reduce errors by looking at multiple indicators. This is called a constellation approach because it addresses instability by considering a “constellation” of symptoms.

2. We screen children too late. With our current system, students aren’t identified until second or third grade, which is too late. Ideally, we could implement a universal screening system, but because current screening measures are not very accurate, this can still lead to issues like false positives: predicting the presence of problem when none exists.

To improve screening of phonological processing, particularly in preschool children, we need to assess memory as well as awareness since they measure nearly the same underlying ability. Another method, reverse screening, can be implemented by using the screeners to identify students who are not at risk.

3. We don’t offer the right support. Students with severe dyslexia may fail to respond to a multi-tiered system of support, are often not provided with appropriate interventions, and can develop negative self-concepts about their ability to do well academically.

Using assistive technology in the form of computer-based text-to-speech or human-recorded audiobooks can help students with reading problems sooner and more comprehensively. According to Wagner, certain factors can affect the maximal benefit. For example, if listening comprehension is no better than reading comprehension, assistive technology may not be beneficial. It is also not yet clear how much time should be spent on intervention versus using assistive technology. Although research is currently studying these specific factors, students can achieve significantly with improved identification, screening, and support.

About the Presenter

Cutting-edge research to support students with reading disabilities

Richard Wagner is the Robert O. Lawton Distinguished Research Professor of Psychology and the Morcom Chair at Florida State University. He also is a co-founder and a current associate director of the Florida Center for Reading Research. His major area of research interest is dyslexia and the normal acquisition of reading. He currently is the principal investigator of a Multidisciplinary Learning Disability Center funded by the National Institute of Child Health and Human Development. He recently served on the California advisory group charged with developing dyslexia guidelines for the state. He has coauthored tests that are commonly used including the Comprehensive Test of Phonological Processing (CTOPP-2), the Test of Word Reading Efficiency (TOWRE-2), and the Test of Preschool Early Literacy (TOPEL).

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About the Author:

Ellen Ullman is editorial director, content services, for eSchool Media.